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[afro-nets] WHO 130th Executive Board Meeting: Day 2 report

  • From: "Claudio Schuftan" <cschuftan@phmovement.org>
  • Date: Thu, 19 Jan 2012 00:36:49 -0800

Highlights from the second day of the 130th Executive Board
Geneva, 17.01.12

Nomination of the Director-General
NGOs were not allowed to attend this session.

Appointment of the Regional Director for the Eastern Mediterranean
At its fifty-eighth session held in Cairo in October 2011, the Regional Committee for the Eastern Mediterranean nominated Dr Ala Din Alwan as Regional Director for the Eastern Mediterranean.

Technical and health matters
*Early marriages, adolescent and young pregnancies *(EB document 130/12) Cameroon was the first country who took the floor on behalf of AFRO. It strongly supported the document, especially the framework on adolescent health services. AFRO urged greater inclusion of youth, improved access to education for all and legislation outlawing marriage before 18 years. Cameroon mentioned insufficient sex education, harmful cultural practices, poverty as the main factors responsible for the high incidence of early marriages and reproductive complications in the region. AFRO also asked to strengthening adolescent health services and reproductive health as well as overcoming cultural barriers.
India proposed a multisectoral approach integrating poverty alleviation, education and adolescent friendly health services by listing the societal effects it has achieved following greater retention of girls in schools (due to the adoption of an education act).
France, Germany and the US considered early marriages a gross violation of fundamental human rights. The US viewed gender violence with concern, especially in the context of adolescent marriages which are largely ignored and wanted to see more concrete links between MDGs 2, 3, 4 and 5 in the report. Germany highlighted the importance of early sex education saying that this was responsible for its very low incidence of cases.
Brunei targeted adolescent pregnancies by utilizing skilled midwives in its primary health care system. Yemen, among other things, recognized the need to reduce gender stereotypes and urged the UN to intensify efforts that consider early marriage and pregnancy as priorities.
Norway, on behalf of the Scandinavian group, and the Netherlands noted that the MDG on maternal and reproductive health were the worst performing and deplored female genital mutilation. They asked for the inclusion of male youth into programmes and opposed a rising tide of resistance to fundamental human rights on sexual freedoms.
The Holy See condemned gender violence and early marriages but was strongly troubled about provisions in the draft that promote access to so called “emergency contraception” and abortion. According to its view, the Vatican refused to defend any legal recognition of abortion which is considered as an antithesis of human rights.
The UNFPA representative stated that child marriage has historically received little attention quoting a UN report pointing out that marriage before 18 years is a violation of human right.
The Special Adviser to DG on Family and Adolescent Matters reminded the EB that the largest cohort of birth ever seen, tagged the “millennium development babies”, were born a decade ago and are now entering adolescence. She urged commitment to protect this cohort.
In conclusion, all regions except the Holy See did not fault the draft, but they urged more integration between MDGs, youth participation and greater multisectoral approach with emphasis on education, friendly health services and legislation.

*Monitoring of the achievement of the health-related Millennium Development Goals*
The discussion on this item will be uploaded as soon as possibile. Social determinants of health: outcome of the World Conference on Social Determinants of Health (Rio de Janeiro, Brazil, October 2011) (EB document 130/15) The afternoon discussion went on with Member States comments on EB Document 130/15: “Social determinants of health: outcome of the World Conference on Social Determinants of Health”. While appreciating the report, all Member States congratulated the Secretariat and the Brazilian Government for the successful conference held in Rio de Janeiro last October. All Member States reaffirmed their commitment and recognized the importance of incorporating Social Determinants of Health (SDH) in all policies through a multi-sectoral approach raising policy makers awareness on this issue. In particular Mozambique, speaking on behalf of the African Region, highlighted the importance of addressing SDH if countries want to achieve the Millennium Development Goals.
The Norwegian delegate definitely made one of the most comprehensive statement. He mentioned equity as common denominator, he recalled the need for a strong WHO to provide technical support and guide Member States in implementing strategies based on a SDH approach, and finally proposed to include SDH in non-communicable diseases monitoring.
It is important to report that Switzerland proposed to held a High Level Meeting on SDH in 2013. The Swiss delegate also questioned the health sector capacity to effectively engage in true dialogue with other sectors to develop coherence. As an example, he reported that “in Rio, we seemed to only have health ministries represented. We didn't really have a multi-sectoral approach".
The last who took the floor was the civil society with the statement by Medicus Mundi International (MMI) and People’s Health Movement (PHM). While recognizing that the Rio Conference was an excellent initiative, MMI and PHM stated that the opportunity to purposively build upon the valuable report of the Commission on Social Determinants of Health was actually missed. They urged Member States to consider the following as imperatives while addressing the SDH:
1. Building and strengthening of equity-based social protection systems and effective publicly provided and publicly financed health systems.
2. Use of progressive taxation, wealth taxes and the elimination of tax evasion to finance action on the social determinants of health.
3. Use of health impact assessments to document the ways in which unregulated and unaccountable transnational corporations and financial institutions on the one hand, and the global trading regime on the other, constitute barriers to Health for All.
4. Reconceptualisation of aid for health as an international obligation and reparation, that is legitimately owed to developing countries under basic human rights principles.
5. Development and adoption of a code of conduct in relation to the management of institutional conflicts of interest in global health decision making.
6. Development of monitoring systems that provide disaggregated data on a range of social stratifiers as they relate to health outcomes.

The discussion on the resolution on SDH proposed by Brazil, Chile and Ecuador closed this session. The main objectives of this resolution would be the endorsement of the Rio Declaration by WHA 65th as well as the inclusion of SDH as a priority in the WHO reform process. Estonia, on behalf of European Union, and Canada requested to shorten the Rio Declaration and build the resolution on it without going beyond the wording there used.

Alice Fabbri (PHM)